MercyOne Genesis DeWitt Medical Center
1118 11th Street, DeWitt, IA · MercyOne · · NPI 1407938269
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Ped crit care age 2-5 init CPT 99475 | $1,130.40 | $1,884.00 | $928.00 – $2,679.00 | 3 |
| Ped crit care age 2-5 subsq CPT 99476 | $685.80 | $1,143.00 | $834.39 – $2,679.00 | 3 |
| Ped crit care transport CPT 99466 | $525.60 | $876.00 | $639.48 – $2,679.00 | 3 |
| Ped crit care transport addl CPT 99467 | $246.60 | $411.00 | $300.03 – $2,679.00 | 3 |
| Ped critical care initial CPT 99471 | $1,653.00 | $2,755.00 | $928.00 – $1,949.83 | 3 |
| Ped critical care subsq CPT 99472 | $811.20 | $1,352.00 | $928.00 – $2,679.00 | 3 |
| Pedicle enel/ntroral 15576 CPT 15576 | $1,545.60 | $2,576.00 | $928.00 – $2,679.00 | 3 |
| Pegaspargase injection HCPCS J9266 | $47,536.40 | $79,227.33 | $13,540.19 – $29,071.58 | 3 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $11,379.97 | $18,966.61 | $6,448.65 – $13,845.63 | 3 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $7,407.18 | $12,345.30 | $4,197.40 – $9,012.07 | 3 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $7,407.18 | $12,345.30 | $4,197.40 – $9,012.07 | 3 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $1,521.60 | $2,536.00 | $862.24 – $1,851.28 | 3 |
| Pelvic CT scan (with contrast) CPT 72193 | $1,434.00 | $2,390.00 | $812.60 – $1,744.70 | 3 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,170.60 | $1,951.00 | $663.34 – $1,424.23 | 3 |
| Pelvic MRI (with and without contrast) CPT 72197 | $2,616.00 | $4,360.00 | $1,354.90 – $2,909.05 | 3 |
| Pelvic MRI (with contrast) CPT 72196 | $1,741.20 | $2,902.00 | $986.68 – $2,118.46 | 3 |
| Pelvic MRI (without contrast) CPT 72195 | $1,576.80 | $2,628.00 | $893.52 – $1,918.44 | 3 |
| Pelvic Ultrasound (complete) CPT 76856 | $373.80 | $623.00 | $140.89 – $211.82 | 3 |
| Pelvic Ultrasound (limited) CPT 76857 | $213.60 | $356.00 | $121.04 – $204.40 | 3 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $172.80 | $288.00 | $73.00 – $97.92 | 3 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $243.00 | $405.00 | $137.70 – $295.65 | 3 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $10,270.83 | $17,118.05 | $5,820.14 – $12,496.18 | 3 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $7,202.36 | $12,003.94 | $53.57 – $115.02 | 3 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $1,351.83 | $2,253.05 | $220.90 – $474.28 | 3 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $119.73 | $199.55 | $19.81 – $42.52 | 3 |
| Penicillin g procaine inj HCPCS J2510 | $149.24 | $248.74 | $53.16 – $114.14 | 3 |
| Perc rf ablate renal tumor CPT 50592 | $6,211.20 | $10,352.00 | $928.00 – $7,556.96 | 3 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $522.12 | $870.20 | $295.87 – $635.25 | 3 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | $570.00 | $950.00 | $693.50 – $2,679.00 | 3 |
| Pericardiectomy/sub or com/w bypas 33031 CPT 33031 | $4,681.20 | $7,802.00 | $928.00 – $5,695.46 | 3 |
| Pericardiocentesis wwo imaging CPT 33016 | $584.40 | $974.00 | $711.02 – $2,679.00 | 3 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | $1,898.40 | $3,164.00 | $928.00 – $2,679.00 | 3 |
| Peri-implt capslc brst compl CPT 19371 | $1,515.00 | $2,525.00 | $928.00 – $2,679.00 | 3 |
| Perineoplasty rpr per nonob CPT 56810 | $506.40 | $844.00 | $616.12 – $2,679.00 | 3 |
| Peritoneal cath sub q resv per CPT 49419 | $844.20 | $1,407.00 | $928.00 – $2,679.00 | 3 |
| Perq dev breast 1st mr guide CPT 19287 | $3,855.60 | $6,426.00 | $2,080.80 – $4,467.60 | 3 |
| Perq dev breast 1st strtctc CPT 19283 | $3,742.20 | $6,237.00 | $1,346.40 – $2,890.80 | 3 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $162.00 | $270.00 | $197.10 – $2,679.00 | 3 |
| Perqt bx lung/mediastinum 32405 CPT 32405 | $213.00 | $355.00 | $259.15 – $2,679.00 | 3 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | $855.00 | $1,425.00 | $928.00 – $2,679.00 | 3 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $12,121.85 | $20,203.09 | $6,869.05 – $14,748.26 | 3 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | $24,690.36 | $41,150.60 | $9,334.92 – $20,042.62 | 3 |
| Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 | $88.80 | $148.00 | $43.52 – $93.44 | 3 |
| Pessary reusable rub anytype HCPCS A4561 | $1.80 | $3.00 | $2.19 – $2,679.00 | 3 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $23,287.80 | $38,813.00 | $0.34 – $0.73 | 3 |
| Phalangectomy ea toe 28150 CPT 28150 | $822.00 | $1,370.00 | $928.00 – $2,679.00 | 3 |
| Pharmacologic management w/psytx CPT 90863 | $44.40 | $74.00 | $54.02 – $2,679.00 | 3 |
| Ph body fluid CPT 83986 | $36.00 | $60.00 | $20.40 – $43.80 | 3 |
| Phencyclidine (pcp) CPT 83992 | $306.00 | $510.00 | $114.24 – $245.28 | 3 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $112.72 | $187.87 | $9.54 – $20.48 | 3 |
| Phenobarbital therapeutic drug level CPT 80184 | $128.40 | $214.00 | $22.44 – $48.18 | 3 |
| Phentolaine mesylate inj HCPCS J2760 | $755.97 | $1,259.95 | $157.59 – $338.36 | 3 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $16.01 | $26.69 | $8.29 – $17.80 | 3 |
| Phenytoin total therapeutic drug level CPT 80185 | $148.80 | $248.00 | $25.84 – $55.48 | 3 |
| Phlebotomy therapeutic CPT 99195 | $159.60 | $266.00 | $90.44 – $194.18 | 3 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | $1,294.80 | $2,158.00 | $928.00 – $2,679.00 | 3 |
| Phleb veins 1 extrm >20 stab CPT 37766 | $1,531.80 | $2,553.00 | $928.00 – $2,679.00 | 3 |
| Phone e/m phys/qhp 11-20 min CPT 99442 | $82.20 | $137.00 | $100.01 – $2,679.00 | 3 |
| Phone e/m phys/qhp 21-30 min CPT 99443 | $116.40 | $194.00 | $141.62 – $2,679.00 | 3 |
| Phone e/m phys/qhp 5-10 min CPT 99441 | $50.40 | $84.00 | $61.32 – $2,679.00 | 3 |
| Phosphorus CPT 84100 | $37.80 | $63.00 | $21.42 – $45.99 | 3 |
| Phosphorus 24 hour urine CPT 84105 | $32.40 | $54.00 | $10.88 – $23.36 | 3 |
| Physical Therapy Evaluation (high complexity) CPT 97163 | $272.40 | $454.00 | $56.78 – $97.09 | 3 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $233.40 | $389.00 | $51.68 – $110.96 | 3 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $245.40 | $409.00 | $54.40 – $116.80 | 3 |
| Physical Therapy Re-Evaluation CPT 97164 | $240.60 | $401.00 | $36.72 – $64.97 | 3 |
| Physician standby services CPT 99360 | $146.40 | $244.00 | $178.12 – $2,679.00 | 3 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $99.15 | $165.25 | $11.80 – $25.34 | 3 |
| Pierce earlobes 69090 CPT 69090 | $49.20 | $82.00 | $59.86 – $2,679.00 | 3 |
| Pin caspar distraction 12mm HCPCS C1821 | $11,925.00 | $19,875.00 | $9.52 – $20.44 | 3 |
| Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050 CPT 15050 | $1,083.60 | $1,806.00 | $928.00 – $2,679.00 | 3 |
| Pin finger fracture each CPT 26756 | $600.60 | $1,001.00 | $730.73 – $2,679.00 | 3 |
| Pinworm exam CPT 87172 | $33.60 | $56.00 | $15.98 – $34.31 | 3 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $78.80 | $131.34 | $13.30 – $28.56 | 3 |
| Place duod/jej tube perc CPT 49441 | $2,277.00 | $3,795.00 | $928.00 – $2,770.35 | 3 |
| Place gastrostomy tube open 43832 CPT 43832 | $1,987.20 | $3,312.00 | $928.00 – $2,679.00 | 3 |
| Place gastrostomy tube perc CPT 49440 | $2,054.40 | $3,424.00 | $928.00 – $2,679.00 | 3 |
| Placement occlusive device venous/arterial access site post procedure HCPCS G0269 | $319.20 | $532.00 | $388.36 – $2,679.00 | 3 |
| Placement of seton CPT 46020 | $514.20 | $857.00 | $625.61 – $2,679.00 | 3 |
| Placement stent(s) intravascular transcatheter artery initial CPT 37236 | $744.00 | $1,240.00 | $905.20 – $2,679.00 | 3 |
| Place non-slctv cath thoracic arta CPT 36221 | $2,090.40 | $3,484.00 | $928.00 – $2,679.00 | 3 |
| Place slctv cath carotd art uni CPT 36224 | $1,749.00 | $2,915.00 | $928.00 – $2,679.00 | 3 |
| Place slctv cath carotid/inom art excrn uni CPT 36222 | $1,219.80 | $2,033.00 | $928.00 – $2,679.00 | 3 |
| Place slctv cath subclavian art CPT 36225 | $2,868.00 | $4,780.00 | $928.00 – $3,489.40 | 3 |
| Place slctv cath vertebral art uni CPT 36226 | $1,749.00 | $2,915.00 | $928.00 – $2,679.00 | 3 |
| Platelet aggregation each agent teg CPT 85576 | $79.20 | $132.00 | $44.88 – $96.36 | 3 |
| Platelet automated CPT 85049 | $28.80 | $48.00 | $13.26 – $28.47 | 3 |
| Platelets hla matched leukocytes reduced apheresis/pheresis each unit HCPCS P9052 | $1,573.80 | $2,623.00 | $891.82 – $1,914.79 | 3 |
| Plcmnt stent transcath ctrl dialysis seg add-on CPT 36908 | $347.40 | $579.00 | $422.67 – $2,679.00 | 3 |
| Plcmt dlyd xtn pros 1st vsl CPT 34710 | $1,210.20 | $2,017.00 | $928.00 – $2,679.00 | 3 |
| Plcmt xtn pros evasc rpr per vsl CPT 34709 | $693.00 | $1,155.00 | $843.15 – $2,679.00 | 3 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $324.60 | $541.00 | $31.39 – $93.50 | 3 |
| Pleurectomy parietal ; separate 32310 CPT 32310 | $1,386.00 | $2,310.00 | $928.00 – $2,679.00 | 3 |
| Pneum full leg splnt pre ots HCPCS L4370 | $34.20 | $57.00 | $41.61 – $2,679.00 | 3 |
| Pneumothrx tx-intraplrl inj ai CPT 32960 | $263.40 | $439.00 | $320.47 – $2,679.00 | 3 |
| #pnh-flow cytometry interp CPT 88187 | $61.80 | $103.00 | $35.02 – $75.19 | 3 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $133.80 | $223.00 | $56.44 – $121.18 | 3 |
| Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 | $33,005.93 | $55,009.88 | $4,026.31 – $8,644.72 | 3 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $3,262.80 | $5,438.00 | $854.10 – $1,848.92 | 3 |
| Portable 02 contents, gas HCPCS E0443 | $27.00 | $45.00 | $32.85 – $2,679.00 | 3 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.